Introduction Case Study

Western Mindanao State University
COLLEGE OF NURSING
Zamboanga City
S.Y 2019 – 2020
In Partial Fulfillment
of the Requirements in
Nutrition and Diet Therapy Laboratory
A case presentation on
Cold Liquid Diet for a Wisdom Tooth Extracted Patient
Submitted by:
Anggaos, Iris D.
Atong, Mohammad Rashid C.
Cambonga, Ralph Eugene G.
Chavez, Angelica Blanche A.
Mendoza, Via Valein B.
Mojica, Noah Kent
Velez, Hilary T.
Villarba, Joshua Benjamin S.
ACKNOWLEDGEMENT
This case presentation on Cold Liquid Diet would not be possible without the guidance,
assistance and cooperation of special persons mentioned herein. The researchers are therefore
will like to express their sincere and deep gratitude to the following:
Prof. Sherianne A. Ahari for lending the researchers some reference to ponder-on about
the aforesaid study;
Prof. Narhuda H. Unga for imparting her knowledge and time before and during the
conduction of our case presentation;
To our parents and guardians, for their moral support, unconditional love, patience and
understanding, who they have been our main motivating part in the attainment of this project;
and
Above all, to our – Heavenly Father for his magnanimity and spiritual guiding light
which sustained us to the end of our work.
TABLE OF CONTENTS
CHAPTER PAGE
Title Page i
Acknowledgement ii
Table of Contents iii
I. Introduction 1
1.1 Aims of Study 1
1.2 Aims of Cold Liquid Diet 1
1.3. Guidelines of Preparing Cold Liquid Diet 1
1.4 Definition of Terms 1
II. Characteristics 2
2.1 Food Allowed 2
2.2 Food Not Allowed 2
III. Indications for Use 2
IV. Client’s Profile 3
4.1 Medical History 3
4.2 Socio-economic Background 3
4.3 Dietary History 4
V. Feeding Administration/Interval of Feeding 5
VI. Sample Menu 6
VII. Computation 7
7.1 Desired Body Weight 7
7.2 Body Mass Index 7
7.3 Total Energy Requirement 7
7.4 Dietary Prescription 8
7.5 Food Exchange List 8
7.6 Distribution of Exchange 9
I. Introduction
Cold Liquid Diet also termed as “T and A diet” is a food preparation that involves
serving cold and iced liquids. An individual may experience fever, difficulty swallowing, sore
throat and pain when he has undergone tonsillectomy, adenoidectomy and tooth extraction.
Although the condition is commonly experienced by people of all ages, its frequency is slightly
higher among children. Prescribed diet exclusive for the client are effective in managing the
condition.
1.1 Aims of the Study

This study aims to help the health care personnel on what foods must be served for this
particular diet to the patient and for the students to be able them use this research for future
references.
1.2 Aims of the Diet

1. To rest and promote relief to the organ included
2. To avoid irritation at the side of the resection
3. To minimize pain in oral cavity
4. To avoid bleeding of operated area
5. To promote rapid wound healing
6. To replace nutrient losses
7. To provide oral source of fluids for individual who are incapable of chewing, swallowing, or
digesting solid food
1.3 Guideline of Preparing Cold Liquid Diet
• C – Consult a nutritionist or a doctor before initiating this diet. The cold liquid diet
is not nutritionally adequate. Hence, you should not risk your health without proper
medical advice.
• O – Only soothing fluids are allowed in this diet. Selected items should be free from
irritants and acid preparations. Wine, alcoholic beverages, coffee and etc. are strong
irritants and should be avoided.
• L – Let the client shift to mechanical soft diet first before launching this diet. The
process of shifting the diet to cold liquids should be gradual.
• D – Duration of the diet should only be two to three days to avoid risking your
health condition. A high protein beverage can be served between meals to provide
nutrients needed by the body.
1.4 Definition of Term
1. Cold Liquid Diet

 A food preparation that consists of cold or iced smooth liquids and semi-liquids. This diet
varies depending on the severity of the patient’s condition, age and overall health status.
II. Characteristics
Cold liquid diet is sometimes referred to as T and A diet after tonsillectomy and
adenectomy. Cold fluids are given to prevent bleeding of the operated area which consist of food
or iced smooth liquids All liquids are served cold or iced or food that have been allowed to cool
may also be given
Food Allowed
 Plain ice cream, iced milk, iced tea, iced coffee, soft drinks, gelatin (other than red,
orange and dark-colored), cooked soft and bland foods which have been cooled are
allowed.
Food Not Allowed

 Acidic or sour fruit juices, wine and alcoholic beverages, and hot soups or foods are
highly avoided. Tea and coffee should also be avoided. All orange, red and chocolate
foods are to be eliminated after surgery or to people suspected of bleeding.
III. Indication for Use
This is kind of diet therapy are being used for patient who have undergone tonsillectomy,
dental extraction, other minor operation on the mouth or throat, and adenoid surgery.
IV. Client’s Profile
Name: Patient L
Age: 30 years old
Address: San Roque, Zamboanga City
Birthday: January 9, 1989
Occupation: Teacher
Gender: Female
Birthplace: Zamboanga City
Educational Level: BSED Graduate
Date of Admission: May 05, 2017
Chief Complain: Toothache
Admitting Diagnosis: Impacted wisdom tooth
Attending Physician: N/A
4.1 Medical History
A. Present illness and chief complain

 None
B. Past illness and surgery, allergies, hospitalization, etc.
 Had wisdom tooth removal two years ago.
 Allergic to shrimps and eggplant
C. Physical state of health: height and weight, appetite, digestion and elimination
problems, nutriture, etc.
 Client is 5’0 ft tall and weighs 47 kg. She has good appetite and claimed to have
no elimination problem.
D. History of parents’ illness
 Her father died because of stroke and her mother have diabetes
4.2 Socio-Economic Background
a. Ancestry of ethnic background

 Born in Zamboanga. Her father is a public servant while her mother is a private
school teacher
b. Composition of the Family
 Nuclear
c. Occupation
 High School Teacher
d. Educational Attainment
 BSED major in Science graduate
e. Religion
 Roman Catholic
f. Type of Residence
 Lives with family
g. Income Bracket
 Client refused to disclose
h. Recreation, exercise, hobbies
 Jogging every Sunday if free
4.3 Dietary History
A. Food likes and dislikes

 Likes sweet food such as cakes, chocolate, ice cream
 Hates spicy foods, eggplant, and shrimp
B. Typical food intake
 Breakfast- bread, milk, rice, and egg
 Lunch- fish and rice
 PM snack- banana and ice tea
 Dinner- rice and fish
C. Frequency of meals and time eaten
 Eats three meals a day plus one snack in the afternoon. Sometimes skip breakfast if
running late for work
D. Cooking facilities
 Uses gas stove at home and buys food from the school canteen if at work
E. Food budget per person
 Prepares 70 pesos for lunch if at school
F. Other sources of nutrients in addition to usual food and drink
 Takes Usana Essential
G. Past dietary restrictions and medical reasons
 Restricted to eat hot and solid food after wisdom tooth removal
H. Nutritional knowledge and where obtained
 Client doesn’t have nutritional knowledge as she eats what is available
4.4 Dietary Needs While in the Hospital
a. Food likes and dislikes

 Likes ice cream or any cold drinks
 Doesn’t eat any solid food
b. Present dietary prescription and rationale
 Not available
c. Appetite: ability to chew; vomiting, cramps or abdominal distentions
d. Any physical handicap
 None
e. Food tolerance
 None
f. Need for dietary instruction
 Less amount of sugary foods and cholesterol intake due to family history illness
occurred.
V. Feeding Administration//Interval of Feeding
Cold liquid Diet is given on the first day after surgery
Day 1 – Ice chips or sips of cold water are given progressing with cold milk and non-
irritating fruit juices
Day 2 – Cold liquids, gels, and ice are added for example like ginger ale, gelatin, bland
strained fruit juice, plain ice cream and weak iced tea or coffee. For some other patients who can
tolerate plain pudding, custard and 3-minute egg is given before the 3rd day
Day 3 & 4 – Strained warm cream soups, fruit and vegetable puree, soft – cooked eggs,
strained warm cereals, milk, cheese, butter, lugao or gruel and mashed potatoes are added to the
cold liquid diet
Day 5 – Soft to liquid diet is prescribed

VI. Sample Menu
Breakfast
1. Watermelon shake
2. Cold thin oatmeal with milk
Lunch
1. Cold Squash soup
2. Chilled gulaman
3. Protein smoothie
Dinner
1. Lugar
2. Ice juices
AM snack
1. Ice cream
2. Cold water
PM Snack
1. Popsicles
2. Cold water
Midnight Snack
1. Chilled gulaman drink

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Western Mindanao State University

1.1 Aims of the Study

1.2 Aims of the Diet

1.3 Guideline of Preparing Cold Liquid Diet

1. Cold Liquid Diet

Food Not Allowed

III. Indication for Use

4.1 Medical History

A. Present illness and chief complain

4.2 Socio-Economic Background

a. Ancestry of ethnic background

4.3 Dietary History

A. Food likes and dislikes

4.4 Dietary Needs While in the Hospital

a. Food likes and dislikes

Cold liquid Diet is given on the first day after surgery

irritating fruit juices

cold liquid diet

Day 5 – Soft to liquid diet is prescribed

2. Cold thin oatmeal with milk

1. Cold Squash soup

1. Chilled gulaman drink

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